AccountId: 011433970860
ContactId: 571d69a3-2bfb-4d7a-b64a-fa369c5cd965
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 140449 ms
Total Talk Time (AGENT): 72999 ms
Total Talk Time (CUSTOMER): 37979 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/571d69a3-2bfb-4d7a-b64a-fa369c5cd965_20250128T16:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, I'm calling from EST just set pediatrics. I'm calling regarding this supplemental insurance, trying to find out what it covers and
[CUSTOMER][NEUTRAL] Does it cover office visits or did you
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure, yeah, I can check those benefits for you. Let's get that policy pulled up. Uh, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] Um, it is 05, excuse me, 02588702.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] Alright, and then what was the name and date of birth for the member?
[CUSTOMER][NEUTRAL] Um, well, one of her, her children, one of them is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you for verifying that.
[AGENT][NEUTRAL] Alrighty, so this policy is active. Uh, effective date was [PII], um, and so as this is a secondary medical policy, in short, is designed to help with co-pay, deductible and co-insurance after major medical pays.
[AGENT][NEUTRAL] Um, let me double check to see if office visits are covered under this policy. Give me just a moment.
[AGENT][NEUTRAL] Alrighty and of course I will let you know, Robin verification of coverage is not a guarantee of payment for claims. So for this policy office visits themselves are not going to be covered, however, treatment received in office could be.
[CUSTOMER][NEUTRAL] OK, well that that makes sense.
[AGENT][NEUTRAL] If it were just simply like a consultation, uh, the visit itself is not going to be covered, but if treatment is received in office, such as diagnostic tests, things like that, uh, that could be covered.
[CUSTOMER][POSITIVE] OK, OK, alright, thank you.
[AGENT][NEUTRAL] Yeah, was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Oh, that's it.
[AGENT][POSITIVE] Alright, well thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Thanks bye bye bye.
[AGENT][NEUTRAL] Bye.